Provider Demographics
NPI:1174820088
Name:LARKIN, RICHELLE CHARNESE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:RICHELLE
Middle Name:CHARNESE
Last Name:LARKIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4345 LEE HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-3507
Mailing Address - Country:US
Mailing Address - Phone:216-894-2072
Mailing Address - Fax:
Practice Address - Street 1:4345 LEE HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-3507
Practice Address - Country:US
Practice Address - Phone:216-894-2072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-12
Last Update Date:2011-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH135456164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse